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Prostate Brachytherapy Treatment

The use of ionizing radiation to kill cancer cells is known as brachytherapy; it is one of the most commonly used of the prostate cancer treatment options.

What is Brachytherapy?

The term brachy comes from the Greek for ‘short distance’ so brachytherapy literally means a short therapy.

The brachytherapy for prostate cancer treatment involves the placement of radioactive material either directly onto malignant material (interstitial brachyterapy) or close to it on adjacent tissue, and is therefore a form of radiation therapy for prostate cancer. Brachytherapy works by extinguishing the DNA that is contained within the cancerous cell; without DNA a cell is unable to go through mitosis and therefore can not subdivide and create copies of itself, this ultimately results in the death of the cancer cell.

The use of brachytherapy as a seed radiation treatment for prostate cancer is very effective in the fight against early stage prostate cancer, and is typically used for patients who have small prostate tumours that are confined to a specific region of the prostate and are unlikely to spread to neighboring parts of the body. Although it has been utilised by doctors since the turn of the 20th century, it is only in recent years that it has come to the forefront in the battle against prostate cancer due to much improved medical equipment.

One of the major advances in brachytherapy prostate cancer treatment has been in the field of ultrasound; this has allowed radioactive material to be placed within the cancerous areas of the prostate with great accuracy. This has been highly beneficial to prostate cancer sufferers as high doses of ionising radiation can be placed in the malignant areas whilst limiting damage to the health adjacent structures such as the rectum or bladder.

Low dose rate brachytherapy (LDR Brachytherapy)

This brachytherapy prostate technique involves small radioactive seed implants to be inserted into the prostate. These low dosage seeds are left in place permanently and are similar in size to a grain of rice. The amounts of seeds that are implanted are dependent upon the malignant area of the prostate; this number is generally in the region of 50 to 100 brachytherapy seeds. The low dose rate radium normally comes from either radioactive iodine or radioactive palladium. Urinary side effects may occur from the use of either iodine or palladium; the side effects from brachytherapy using iodine are less intense but longer lasting than those associated with palladium.

High dose rate brachytherapy (HDR Brachytherapy)

In this type of prostate brachytherapy high dosage radioactive materials are temporary placed in the vicinity of the prostate cancer for a short period of time. The source of radiation for high dose rate brachytherapy is normally iridium. The radiation is delivered to the malignant area by the use of catheters. The hdr brachtherapy treatment typically takes two days and consists of three or four sessions. The hdr brachytherapy form of cancer treatment is generally given in conjunction with external beam radiation therapy.

For patients who have large bladders it is often necessary to follow a course of hormones to reduce the size of the prostate or to have treatments other than brachytherapy such as external beam radiation therapy or surgery.